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Medical Pearls from the Internet Medical Association

A rapid strategy to evaluate patient with suspected acute myocardial infarction included a baseline high sensitivity cardiac troponin T level, a repeat level in 1 hour, and observation care for equivocal cases. Within 1 hour, 40% of patients were classified as ruled-in or ruled-out, and 60% went on to observation care. The sensitivity and negative predictive value in the ruled-out group was over 99%. 30-day mortality was 0% in the ruled out group.

Comment: Applying this protocol would greatly decrease costs by decreasing standard observation care by categorizing patients quickly (within 1 hour).

CMAJ 2015. DOI:10.1503 /cmaj.141349    (retrieved Apr, 2015). There are currently 1038 pearls in the database. While every attempt has been made to ensure accuracy, mistakes can and do occur. Use databank at your own risk. All pearls © 2020 by the Internet Medical Association. Click Here to view more medical pearls.